What contraception is best after giving birth?

Understanding just how fertile you are after giving birth and knowing when to start using contraception is key because the fact is that pregnancy is possible soon after birth 

One of the sexy advantages of knowing you’re pregnant is also knowing you can forget about contraception until baby has arrived. 

But don’t believe the old wives’ tales that breastfeeding protects or that you can’t get pregnant until you’ve had a period. Unless you want two babies in less than a year, get your birth control sorted – ideally before you go into labour.

What about breastfeeding? Yes, if your baby is being exclusively breastfeed – no extra formula feeds – there is possibly some protection and you may find your periods don’t come back for a few months. But you can get pregnant before having a period, and the protective effect is by no means fool proof. Better by far not to risk it.
 
In a survey of Bounty mums conducted by the British Pregnancy Advisory Service, a quarter of new mums start having sex again by 6 weeks after having a baby - while more than one in ten wait longer than 6 months. The survey of more than 1,300 new mums also suggested that women are waiting longer than in previous generations to resume sex after childbirth. Research from the 1970s indicated many women started having sex again between the 2nd and 4th week after birth.

The survey also showed that many new mothers will need access to contraception before the 6-8 week postnatal check when it is usually discussed, and fewer than a quarter of mothers said they found it "easy" to get their chosen contraceptive.
  
Clare Murphy of the British Pregnancy Advisory Service said: " We regularly see women experiencing unplanned pregnancy in the year after giving birth, sometimes because of confusing information about breastfeeding and contraception".

There are several effective contraceptive methods which can be used while exclusively or partially breastfeeding, including the mini-pill, coil and implant and emergency contraception (the Levonelle morning-after-pill).  However, knowledge about the safety of these methods is poor, with most mothers believing only condoms can safely be used. 

So what method – and when? 

Condoms are ok whenever you choose to have sex again. You can also ask for and rely on the implant, the contraceptive injection or the progestogen-only pill anytime after the birth. That’s why it’s important to have discussed it before the birth, so you can be given your choice immediately or have an appointment with your GP ready.

You could also have an IUD inserted within 48 hours of birth. But if you don’t get it in that window you need to wait a month for that method. Use barrier methods meantime.
 
What about the pill? You can go on the combined pill three weeks after birth, as long as your doctor has assessed you and cleared you for any medical risk factors. You could also use a vaginal ring or contraceptive patch at this stage with the same provisos as they use the same ingredients. If there are some risks, around blood clots after your birth for instance, you would need to use a barrier method until you are clear.
 
And the cap? You need to wait six weeks and get measured again – childbirth, gaining or losing weight, can mean you may need another fit.
 
Whether you will be breastfeeding or might want to become pregnant again fairly quickly – or REALLY don’t want to risk it – are all issues you need to think and talk over, with your partner and with a doctor, since the methods of contraception may be affected by these issues. The combined pill, for instance, can reduce milk flow so is not recommended while you breastfeed. 

You may think “Is it worth it?”. Immediately after the birth you may be feeling you’re NEVER going to make love again, so why bother even thinking about it?! But once you’ve both got home and are over the shock of becoming sole carers of your beautiful baby, you may find unexpected amorous feelings overtake you. If you think feeling tired and frazzled may make it hard to keep to the daily routine of some methods of contraception, consider methods such as injection, implant or IUD. Change your mind and they can be removed or allowed to run out. Or have those condoms to hand and use them every time.

Bounty “Sex & Relationship” articles are written by expert Suzie Hayman. Suzie is agony aunt for Woman magazine, a Relate trained counsellor, and an accredited TripleP (Positive Parenting Programme) parenting educator.  She makes frequent appearances on TV and radio and as well as writing 31 books, Suzie writes features on parenting, relationships, sex and couples counselling, for a wide range of national magazines and newspapers